A Japanese traditional medicine Hochuekkito promotes negative conversion of vancomycin-resistant Enterococci

Vancomycin-resistant enterococci (VRE) are prominent causes of nosocomial infections. Japanese traditional (Kampo) medicine promotes intestinal immunity and protects against bacterial infections. We assessed potential differences in the clinical course of VRE-positive patients, based on their characteristics and treatment with Kampo medicines. This retrospective observational study collected data from VRE-positive patients from August 2018 to July 2019 at a tertiary-care hospital in Japan. The data of 122 consecutive VRE-positive inpatients were analyzed. Sixty-nine patients were treated with probiotics, among whom, 18 were further treated with Kampo medicines. Twenty-six of the 122 patients subsequently died. In univariate analyses, subsequent VRE negative conversion significantly reduced the mortality of VRE-detected patients (p=.0003). Administration of probiotics (p=.0065) and Kampo medicines with probiotics (p=.0002), especially of the Kampo medicine hochuekkito (p=.0014), and a higher serum albumin level positively contributed to the subsequent VRE negative conversion. Multivariate analyses demonstrated that Kampo medicines and body mass index contributed to VRE negative conversion. Hochuekkito shortened the time needed for VRE negative conversion (p=0.0485). Administration of Kampo medicines, especially of hochuekkito, in addition to probiotics in VRE patients may promote VRE negative conversion.

Automated summary

Traditional Japanese (Kampo) medicines, particularly hochuekkito, may facilitate VRE (vancomycin-resistant enterococci) conversion in patients, reducing mortality. Probiotics usage and higher serum albumin levels are also associated with VRE conversion.